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Several surgical techniques like are today available in order to recovery large bone defects of the jaw. Aim of the surgeon is to obtain a good tridimensional volume to place dental implant and to recovery the patient’s aesthetics and function. Several prosthetic solution were considered for prosthetic rehabilitation. However after a bone graft surgery Toronto screwed prosthesis on dental implants, following Branemark intuitions, was considered the better prosthetic rehabilitation solution. According to Wölff, the dental implants osteointegration is related to the strengths directed to mandibular bone. Our investigation’s aim is to underline through FEM analysis the stress over the prosthetic elements and over bone surface in order to help the surgeon choice about the dental implant positioning, and at the same time reducing the bone trauma on the patients.

OBJECTIVE: To evaluate the different behavior of two different human adult adipocytes derived stem cells (hASCs) during proliferation and osteogenic differentiation. PATIENTS AND METHODS: Human adult adipocytes stem cells (hAT-SCs) from visceral (hAV-SCs) and subcutaneous (hAS-SCs) sites were obtained after surgery procedures of seven patients. All samples were fully investigated and the different proliferation rates were evaluated. All MSCs clusters were cultured with an osteogenic and adipogenic differentiation medium. Homogeneous pools of Mesenchymal Stem Cells (MSCs) were confirmed by Flow-Cytometry Analysis (FACS) and Spectrophotometric Assay. The differentiated cells were eventually assessed for the expression of Alkaline Phosphatase (ALP), Alizarin Red (AR) and Oil Red-O (OR-O) detection, and analyzed by the Spectrophotometric Assay. After osteogenic differentiation, the cell clusters were incubated and analyzed with Real Time-Polymerase Chain Reaction (qRT-PCR) and fluorescence microscopy. RESULTS: The F ACS a nalysis p erformed on hAT-SCs confirmed the homogenous presence of MSCs in all samples. The ALP, AR stain confirmed the osteogenic differentiation capacity of MSCs towards osteoblast-like-cells. The colorimetric cell metabolic activity (MTS) assay showed an increase in the proliferation rate with different values in both sets hAS-SCs vs. hAV-SCs. CONCLUSIONS: These in vitro findings of both hAS-SCs and hAV-SCs suggested an important role of these stem cells for future clinical use in bone regeneration. Indeed, the final outcomes suggested a better performance of cells coming from subcutaneous adipose tissue vs. those from visceral fat tissue. [ABSTRACT FROM AUTHOR]

Background. Rebuilding atrophied alveolar ridges can present a significant challenge. There is a multitude of treatment options including guided bone regeneration, onlay block grafting, and distraction osteogenesis. Positioning of dental implants can be placed in an immediate or delayed fashion. An advantage of placing implants immediately is that the patient's treatment course is shortened as well as the potential for maintaining soft tissue is present. Methods. The recent FDA approval of recombinant human bone morphogenic protein (rhBMP-2) has given clinicians an added treatment option for reconstructing localized alveolar defects. Several patients have been treated with dental implant and rhBMP-2 and the results were recorded by clinical and radiological exams. Results. The potential to reconstruct these challenging defects with a growth factor thus limiting or even avoiding a secondary harvest site is exciting. We describe our experience with the use of implants and bone morphogenic protein together. This study presents excellent results about the combination of using dental implants and growth factor for treating substantial bone defects. Conclusion. Our goal was to clinically evaluate the potential of a purpose designed titanium porous-oxide dental implant surface combined with rhBMP-2. [ABSTRACT FROM AUTHOR]

The rehabilitation of edentulous patients is today a challenge for the clinicians. The healthy of the hard and soft issue may be considered a fundamental element for having long-term results. The dental implant progresses about the predictable and safe results made this technique chosen from a large group of practitioners. However some problems related intraoperative and postoperative conditions may create discomfort on the patients and consequently to the clinician. The unfavourable results are often related to the bone tissue quality but sometime the dental implant shape and the prosthesis framework may undergo to technical difficulties. The purpose of this work is, through the use of appropriate FEM models, to analyse the effect of all these parameters in the construction of a prosthesis type "Toronto", evaluating all the surgical and prosthetic components in order to direct the choices made by the surgeon and to optimize the distribution of loads reducing the patient's discomfort and having a long term clinical success. [ABSTRACT FROM AUTHOR]